By Christopher Lind, Nerina Scarinci, Carly Meyer, Kristen Tulloch, Karinna Hall, and Louise Hickson
This article is a part of the January/February 2019, Volume 31, Number 1, Audiology Today issue.
More specifically, this article will (1) describe the principles of family-centered practice in adult audiologic rehabilitation, (2) summarize observations of family-centered behaviors in current audiologic rehabilitation, and (3) identify opportunities to increase the family-centeredness of adult audiologic rehabilitation. To address these aims, we will outline the research evidence behind family-centered care (FCC) (the why), and from this, describe how FCC might best be implemented in audiologic rehabilitation. For the purposes of this article, “family” incorporates anyone who plays a significant role in the life of a person with hearing impairment, whether this relationship is biological, legal, or emotional (Kilmer et al, 2010). As such, family extends beyond spouses and adult children to others such as friends, neighbors, colleagues, and employers.
Epley and colleagues (2010) provide us with five key principles of family-centered practice.Perhaps one of the most important principles is that the entire family, not just the person with hearing impairment, should be the unit of attention in rehabilitation.
The broader family unit is acknowledged to be a unique and vital force in addressing the impact of the hearing loss. In developing a clinical relationship, the clinician addresses the impact of the hearing impairment on the family unit.
It is our suggestion that this is one of the keys to engaging families in audiologic rehabilitation. The communication difficulties arising from the hearing impairment on everyday social activity and interaction not only impact the person with hearing impairment but their family as a whole. This has been labeled by the World Health Organization as a “third-party disability.” The changes (often reduction) in everyday activity are experienced by the entire family as a consequence of a family member’s impairment (WHO, 2001; Scarinci et al, 2009, 2012). In establishing and agreeing on goals for overcoming the everyday effects of the hearing impairment, the clinician may seek the input of both the person with hearing impairment and the family. This may help to prioritize the goals and the actions that follow.
What do we know from recent research about the nature and the benefits of FCC? Well, the support of family members in audiologic rehabilitation has been found to (1) increase the likelihood of help-seeking by the person with hearing impairment, (2) assist in decision-making and goal-setting, and (3) promote the successful use of hearing aids (Meyer et al, 2014; Laplante-Lévesque et al, 2010a, 2010b; Hickson et al, 2014).
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